Juliann S Wallner, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

201501705 Issued in NC

Practice address

205 Page Rd
Pinehurst, NC 28374-8749

Phone

(910) 235-3330

Fax

(910) 235-3400

NPI assigned

Aug 18, 2006

Last updated

Oct 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Arizona College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wallj@pinehurstderm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pinehurst Medical Clinic, Inc.

  • Internal Medicine Physician
  • Pinehurst, NC
  • NPI 1255388369
  Medicare reassignment Care Compare group NPD
• Pinehurst Medical Clinic, Inc.

  dba Pinehurst Medical Clinic Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Pinehurst, NC
  • NPI 1356421853
  NPD
• Pinehurst Medical Clinic, Inc.

  dba PMC Reference Lab

  • Clinical Medical Laboratory
  • Southern Pines, NC
  • NPI 1962509372
  NPD (past)
• Center for Advanced Dermatology LLC

  • Dermatology Physician
  • Lakewood, CO
  • NPI 1497765762
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1265546386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748798",
            "telephone_number": "910-295-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748749",
            "telephone_number": "910-235-3330",
            "fax_number": "910-235-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLNER",
        "first_name": "JULIANN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "201501705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #17067)
• James B. Walker, MD
• Latiea Walker
• Tja'Lyza Walker
• Shayla Wallace, MSP, CCC-SLP
• Teresa Walsh, PT, DPT
• Ronald Dean Walters, MD
• Walter Gregory Walton, PH.D.
• Elizabeth Barrineau Ward, LCSW
• Shanice Ward

• Dermatology Physician in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.